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https://www.readbyqxmd.com/read/28697030/severe-postpartum-headache-and-hypertension-caused-by-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#1
Ed McIlroy, Rajamani Sethuraman, Reshma Woograsingh, Catherine Nelson-Piercy, Edward Gilbert-Kawai
Reversible cerebrovascular vasoconstriction syndrome is an uncommon condition that presents as severe headache and hypertension. Recent literature suggests a 1% incidence in postpartum headache cases. It can cause subarachnoid hemorrhages, cerebral ischemia, and seizures. It is often misdiagnosed as postdural puncture headache or preeclampsia. In this case, a postpartum woman, who had received epidural anesthesia for labor, presented 5 days postpartum with severe headache that did not resolve with an epidural blood patch...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#2
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28678308/evaluation-function-of-transcranial-two-dimensional-and-color-doppler-ultrasonography-tccs-for-patients-with-different-degrees-of-cerebral-vasospasm-before-and-after-the-nimodipine-treatment
#3
J-L Wang, X-N Li, Y-H Zhang, X Li, Y-L Yang
OBJECTIVE: To evaluate the changes in cerebral hemodynamics of patients with different degrees of cerebral vasospasm before and after the nimodipine treatment using transcranial two-dimensional and color Doppler ultrasonography (TCCS). PATIENTS AND METHODS: A total of 77 patients with subarachnoid hemorrhage was collected; and the maximum peak systolic velocity (Vs), end diastolic velocity (Vd), time averaged maximum velocity (Vm), pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA) were measured by spectral Doppler technique...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28649230/high-compliance-with-scheduled-nimodipine-is-associated-with-better-outcome-in-aneurysmal-subarachnoid-hemorrhage-patients-cotreated-with-heparin-infusion
#4
Aaron Wessell, Matthew J Kole, Neeraj Badjatia, Gunjan Parikh, Jennifer S Albrecht, David L Schreibman, J Marc Simard
INTRODUCTION: We sought to determine whether compliance with scheduled nimodipine in subarachnoid hemorrhage patients impacted patient outcomes, with the intent of guiding future nimodipine management in patients who experience nimodipine-induced hypotension. METHODS: We performed a retrospective analysis of 118 consecutive aneurysmal subarachnoid hemorrhage patients treated with the Maryland Low-Dose IV Heparin Infusion Protocol. Patients were categorized into three independent nimodipine compliance groups: ≥1 dose held, ≥1 dose split, and no missed or split-doses...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28582545/stereotactic-catheter-ventriculocisternostomy-for-clearance-of-subarachnoid-hemorrhage-in-patients-with-coiled-aneurysms
#5
Roland Roelz, Christian Scheiwe, Horst Urbach, Volker A Coenen, Peter Reinacher
BACKGROUND: Cerebral vasospasm leading to delayed cerebral infarction (DCI) is a central source of poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Current treatments of cerebral vasospasm are insufficient. Cisternal blood clearance is a promising treatment option. However, a generally applicable, safe, and effective method to access the cisterns of the brain is lacking. OBJECTIVE: To report on stereotactic catheter ventriculocisternostomy (STX-VCS) as a method to access the cisterns of the brain for clearance of subarachnoid hemorrhage in patients with aSAH and coiled aneurysms...
June 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28467360/nimodipine-but-not-nifedipine-promotes-expression-of-fatty-acid-2-hydroxylase-in-a-surgical-stress-model-based-on-neuro2a-cells
#6
Eva Herzfeld, Lea Speh, Christian Strauss, Christian Scheller
Nimodipine is well characterized for the management of aneurysmal subarachnoid hemorrhage and has been shown to promote a better outcome and less delayed ischemic neurological deficits. Animal and clinical trials show neuroprotective efficacy following nerve injuries. We showed a neuroprotective effect on Neuro2a cells. Subsequent microarray analysis revealed-among others-fatty acid 2-hydroxylase (FA2H) upregulated by nimodipine in vitro, which is a component of myelin synthesis. Differentiated Neuro2a cells were analyzed for nimodipine-mediated survival considering stress treatment in comparison to nifedipine-treatment...
May 3, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28456915/reversible-cerebral-vasoconstriction-syndrome-recognition-and-treatment
#7
REVIEW
Cecilia Cappelen-Smith, Zeljka Calic, Dennis Cordato
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare but increasingly recognized disorder with over 500 cases published in the literature. The condition is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental narrowing of the cerebral arteries which is reversible within 3 months. RCVS may occur spontaneously but in over 50% of cases, it is associated with various other conditions, including vasoactive medications or illicit drugs and the post-partum state...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28413883/comment-the-effects-of-14-versus-21-days-of-nimodipine-therapy-on-neurological-outcomes-in-aneurysmal-subarachnoid-hemorrhage-patients
#8
Megan Harbin, Ricky Turgeon
No abstract text is available yet for this article.
August 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28397570/is-intra-arterial-nimodipine-really-beneficial-in-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#9
Ashwani Kumar, Manoj Phalak
No abstract text is available yet for this article.
April 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28344178/systemic-and-cerebral-concentration-of-nimodipine-during-established-and-experimental-vasospasm-treatment
#10
Walid Albanna, Miriam Weiss, Catharina Conzen, Hans Clusmann, Toni Schneider, Martin Reinsch, Marguerite Müller, Martin Wiesmann, Anke Höllig, Gerrit Alexander Schubert
BACKGROUND: Oral nimodipine is an established prophylactic agent for cerebral vasospasm after subarachnoid hemorrhage (SAH). In highly selected cases, intra-arterial (IA) or intravenous (IV) application of nimodipine may be considered; however, the optimum dosage and modality of application remain a matter of debate. The purpose of this investigation is analysis of nimodipine concentration in serum, cerebrospinal fluid, and cerebral microdialysate in the context of currently effective dose and route of application (oral, IA, IV)...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28224318/chemical-angioplasty-with-spasmolytics-for-vasospasm-after-subarachnoid-hemorrhage
#11
Aleš Hejčl, Filip Cihlář, Vojtěch Smolka, Petr Vachata, Robert Bartoš, Jan Procházka, Jiří Cihlář, Martin Sameš
BACKGROUND: Clinically symptomatic vasospasm leading to delayed ischemic neurological deficits occurs in up to 30% of patients with subarachnoid hemorrhage (SAH). Vasospasm can result in a serious decline in clinical conditions of patients with SAH, yet the algorithm for vasospasm treatment and prevention remains unclear. Intra-arterial administration of vasodilators is one of the modalities used for vasospasm therapy. METHODS: Over the last 7 years, we have treated 27 female and 7 male patients with vasospasm using intra-arterial administration of either nimodipine or milrinone; all had suffered aneurysm rupture...
February 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28187800/management-of-aneurysmal-subarachnoid-hemorrhage
#12
REVIEW
N Etminan, R L Macdonald
Spontaneous subarachnoid hemorrhage (SAH) affects people with a mean age of 55 years. Although there are about 9/100 000 cases per year worldwide, the young age and high morbidity and mortality lead to loss of many years of productive life. Intracranial aneurysms account for 85% of cases. Despite this, the majority of survivors of aneurysmal SAH have cognitive deficits, mood disorders, fatigue, inability to return to work, and executive dysfunction and are often unable to return to their premorbid level of functioning...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28156162/contribution-of-both-olfactory-and-systemic-pathways-for-brain-targeting-of-nimodipine-loaded-lipo-pluronics-micelles-in-vitro-characterization-and-in-vivo-biodistribution-study-after-intranasal-and-intravenous-delivery
#13
COMPARATIVE STUDY
Hassan M Rashed, Rehab N Shamma, Emad B Basalious
Nimodipine (NM) is the only FDA-approved drug for treating subarachnoid hemorrhage induced vasospasm. NM has poor oral bioavailability (5-13%) due to its low aqueous solubility, and extensive first pass metabolism. The objective of this study is to develop radiolabeled NM-loaded LPM and to test its ability prolong its circulation time, reduce its frequency of administration and eventually target it to the brain tissue. NM was radiolabeled with (99m)Tc by direct labeling method using sodium dithionite. Different reaction conditions that affect the radiolabeling yield were studied...
November 2016: Drug Delivery
https://www.readbyqxmd.com/read/27932607/randomized-open-label-phase-1-2a-study-to-determine-the-maximum-tolerated-dose-of-intraventricular-sustained-release-nimodipine-for-subarachnoid-hemorrhage-newton-nimodipine-microparticles-to-enhance-recovery-while-reducing-toxicity-after-subarachnoid-hemorrhage
#14
RANDOMIZED CONTROLLED TRIAL
Daniel Hänggi, Nima Etminan, Francois Aldrich, Hans Jakob Steiger, Stephan A Mayer, Michael N Diringer, Brian L Hoh, J Mocco, Herbert J Faleck, R Loch Macdonald
BACKGROUND AND PURPOSE: We conducted a randomized, open-label, phase 1/2a, dose-escalation study of intraventricular sustained-release nimodipine (EG-1962) to determine safety, tolerability, pharmacokinetics, and clinical effects in aneurysmal subarachnoid hemorrhage. METHODS: Subjects with aneurysmal subarachnoid hemorrhage repaired by clipping or coiling were randomized to EG-1962 or enteral nimodipine. Subjects were World Federation of Neurological Surgeons grade 2 to 4 and had an external ventricular drain...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27900416/-intensive-care-treatment-after-aneurysmal-subarachnoid-hemorrhage
#15
REVIEW
U Jaschinski
Aneurysmal subarachnoid hemorrhage (SAH) is a devastating disease and nearly one third of patients die in the acute phase. Due to the bleeding event, a hyperactive sympathetic nervous system and an uncontrolled inflammatory response have a profound local and systemic impact on other organ functions. Neuroendocrinological disorders and cardiopulmonary morbidity are dominant. Despite a decrease in hospital mortality for high volume centers, a high proportion of survivors suffer from neurological deficits. Knowledge of the pathophysiology of vasospasms in the later stages of the disease has increased...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27812447/continuous-intra-arterial-nimodipine-infusion-in-refractory-symptomatic-vasospasm-after-subarachnoid-hemorrhage
#16
Raimund Helbok, Alexandra Zangerle, Andreas Chemelli, Ronny Beer, Thomas Benke, Rainer Ehling, Marlene Fischer, Martin Sojer, Bettina Pfausler, Claudius Thome, Erich Schmutzhard
INTRODUCTION: Vasospasm still is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The purpose of this report is to describe the successful management of severe refractory vasospasm with continuous intra-arterial nimodipine (IAN) treatment. CASE DESCRIPTION: A 72-year old right handed woman was admitted with non-traumatic SAH WFNS grade 1. Cerebral computed tomography demonstrated thick blood filling of the basal cisterns, and intraventricular hemorrhage...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#17
REVIEW
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27637674/spontaneous-subarachnoid-haemorrhage
#18
REVIEW
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
February 11, 2017: Lancet
https://www.readbyqxmd.com/read/27593840/comparison-of-the-effects-and-mechanism-of-the-curcumin-with-different-acting-drugs-in-experimental-vasospasm-after-subarachnoid-hemorrhage
#19
Hasan Emre Aydin, Nuriye Ezgi Bektur, Zuhtu Ozbek, Setenay Oner, Cengiz Baycu, Fatma Sultan Kiliç
AIM: Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the most important complication which effects mortality and morbidity of patients with intracranial aneurysm although effective treatment. Today, the mechanisms of vasospasm is not understood in spite of experimetal and clinical researches. The aim of our study to investigate the effect of curcumin which used in medical treatment of some illness and known antioxidant drug on vasospasm following SAH. MATERIAL AND METHODS: In this study, 200-250 gr weight and 64 rats were divided into 7 groups...
May 25, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27474753/verapamil-eluting-stents-as-a-possible-treatment-for-vasospasm-after-subarachnoid-hemorrhage
#20
Pallavi Bhambri, Ali Sarvi, John H Wong, Uttandaraman Sundararaj, Alim P Mitha
OBJECTIVE: The only pharmacologic prophylaxis for cerebral vasospasm after subarachnoid hemorrhage is oral nimodipine. A novel way to mitigate this risk may be to design a drug eluting stent that elutes verapamil over the time period typically associated with vasospasm. In this study, we explore different methods of coating nitinol stents with a bioabsorbable polymer and determine the release profile of various verapamil coated stents for the potential treatment of vasospasm. METHODS: Nitinol stents were coated with different concentrations of poly(lactic acid-co-glycolic acid) (PLGA) in chloroform solution and using three coating techniques: dip coating, spin coating, and electrospinning...
July 29, 2016: Journal of Neurointerventional Surgery
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